Individual
MR. JASON RANDALL PELDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1440 N MAIN STREET, SPEARFISH, SD 57783-1505
(308) 696-8000
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000
(605) 719-7109
(605) 719-1027
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000676
SD
367500000X
Certified Registered Nurse Anesthetist
RO36615
SD
Other
Enumeration date
08/18/2006
Last updated
02/15/2012
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